Jaewon Lee, CNP in Grants, NM - Medicare Nurse Practitioner

Jaewon Lee, CNP is a medicare enrolled "Nurse Practitioner - Family" in Grants, New Mexico. His current practice location is 1217 Bonita St, Grants, New Mexico. You can reach out to his office (for appointments etc.) via phone at (052) 872-9585.

Jaewon Lee is licensed to practice in New Mexico (license number 66164) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1558815522.

Contact Information

	Jaewon Lee, CNP
	1217 Bonita St, Grants, NM 87020-2103
	(052) 872-9585
	(505) 443-8342

Map and Direction

Provider's Profile

Full Name	Jaewon Lee
Gender	Male
Speciality	Nurse Practitioner - Family
Location	1217 Bonita St, Grants, New Mexico
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1558815522
Provider Enumeration Date: 08/08/2016
Last Update Date: 01/15/2025

Medicare PECOS Information:

PECOS PAC ID: 5193004877
Enrollment ID: I20210907002473

Medical Identifiers

Medical identifiers for Jaewon Lee such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1558815522	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	5905 (Minnesota)	Secondary
363LF0000X	Nurse Practitioner - Family	F07161203 (Indiana)	Secondary
363LF0000X	Nurse Practitioner - Family	66164 (New Mexico)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jaewon Lee allows following entities to bill medicare on his behalf.

Entity Name	Dhhs Phs Naihs Crownpoint Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1114960093 PECOS PAC ID: 0143128041 Enrollment ID: O20031230000393

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jaewon Lee is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Jaewon Lee, CNP 1217 Bonita St, Grants, NM 87020-2103 Ph: (052) 872-9585	Jaewon Lee, CNP 1217 Bonita St, Grants, NM 87020-2103 Ph: (052) 872-9585

Reviews and Comments

Nurse Practitioner Nurses in Grants, NM

Miss Dorcas Ann Yates, RN CFNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1010 E Roosevelt Ave, Grants, NM 87020 Phone: 505-287-2948 Fax: 505-287-5372
Patricia Thompson, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2111 Lobo Canyon Rd, Grants, NM 87020 Phone: 505-876-8300 Fax: 505-876-8348
Daniel Edward Fenton Ii, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 801 E Roosevelt Ave, Grants, NM 87020 Phone: 505-658-1347 Fax: 866-422-1014
Lita C Bailly, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1217 Bonita St, Grants, NM 87020 Phone: 505-287-2950 Fax: 505-287-2403
Martha Elia Reyes, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1423 E Roosevelt Ave, Grants, NM 87020 Phone: 505-287-6500
Ms. Martha Abeyta, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1210 Mt. Taylor Ave, Grants, NM 87020 Phone: 505-240-1555 Fax: 505-287-2465

Jaewon Lee, CNP - Medicare Nurse Practitioner in Grants, NM